Department of Cardiovascular Surgery, Tokyo Women's Medical University Hospital, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Department of Cardiology, Tokyo Women's Medical University Hospital, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Gen Thorac Cardiovasc Surg. 2021 Jul;69(7):1137-1139. doi: 10.1007/s11748-021-01621-5. Epub 2021 Mar 26.
We report a case of transcatheter aortic valve implantation in a 79-year-old woman with a coronary anomaly who underwent surgical aortic valve replacement with a 23-mm Abbott Trifecta bioprosthesis. The procedure was performed in response to severe aortic stenosis caused by a bicuspid aortic valve. Computed tomography showed an anomalous origin of the right coronary artery from the left coronary sinus, with an interarterial course. Although the virtual transcatheter valve to coronary ostium distance-right coronary artery was short, the right coronary artery ostium was just behind the stent post. The externally mounted leaflet was unable to reach the coronary orifice beyond the stent post. This case highlights a successful transcatheter aortic valve implantation for stented bioprostheses with externally mounted leaflets when the virtual transcatheter valve to coronary ostium distance is shortened by a coronary anomaly.
我们报告了一例 79 岁女性的经导管主动脉瓣植入术病例，该患者存在冠状动脉异常，曾接受 23 毫米雅培 Trifecta 生物瓣主动脉瓣置换术。该手术是为了治疗由二叶式主动脉瓣引起的严重主动脉瓣狭窄。计算机断层扫描显示，右冠状动脉从左冠状动脉窦异常起源，呈动脉间走行。尽管虚拟经导管瓣环至冠状动脉口的距离-右冠状动脉较短，但右冠状动脉口刚好位于支架柱后面。外置瓣叶无法越过支架柱到达冠状动脉口。当冠状动脉异常导致虚拟经导管瓣环至冠状动脉口的距离缩短时，该病例成功地为带外置瓣叶的支架生物瓣进行了经导管主动脉瓣植入术。
